Emergency department operations leader David Brown and a colleague outside the ED on the night of the Stanley Cup riot.Submitted photo
/ Providence Health Care

St. Paul's Hospital staff at a decontamination station outside the emergency department on the night of the Stanley Cup riot.Submitted photo
/ Providence Health Care

In Vancouver’s downtown core, hordes of rioters were screaming, fighting, smashing windows and bottles, burning cars and looting stores. From outside St. Paul’s hospital, columns of black smoke rising above the buildings and the sound of distant shouting were the only signs of the mayhem unfolding less than a dozen blocks away.

Emergency staff had been put on “Code Orange” alert: prepare for mass casualties — all staff go to their departments, all breaks cancelled, nobody leaves at end of shift. But when the wounded, the pepper-sprayed, the tear-gassed patients began arriving, emergency got so busy that no one remembered to actually call “Code Orange in Effect.”

Nobody had to. Because the 2011 Stanley Cup hockey riot occurred so soon after the 2010 Winter Olympics and staff had prepared for possible cup-final mayhem, St. Paul’s staff were primed and ready to deal with a mass-casualty event.

The night started off quietly in emergency. Even the homeless people who regularly show up at the department were elsewhere, glued to TV sets showing Game 7 of the final, recalls nurse leader Christina Graham. The game was also on in the emergency waiting room. “We knew when we lost,” Graham says. “We knew it was time to step into action.”

Police had already told emergency staff that tear gas and pepper spray would be used if unrest developed. Then staff received word that cops downtown were losing control of the crowds, and considering tear gas. Nurses began filling garbage cans with water and mixing in baby shampoo, which helps neutralize tear gas and pepper-spray residue.

“Anybody who’s been pepper-sprayed or tear-gassed, their first reaction is to run straight to the hospital,” Graham says. Run to the hospital they did. Security guards set up a line to keep out the curious and friends of patients. Nurses outside began conducting pre-triage to determine who needed to be brought in and who could be rinsed off and sent away.

“We were really basically hosing them down and dunking them in buckets,” says nurse Pat Munro.

Those admitted — many with contusions from falls or fighting, others with broken ankles — had to be decontaminated first and have their clothing removed, as residual tear gas and pepper spray could be released inside the building. Many patients, says Graham, were “obviously under the influence,” or as Brown puts it, “piss-drunk.”

Meanwhile, hospital staff — including 15 emergency nurses — who saw the rioting on TV began arriving without being called. One nurse walking from Yaletown had to be escorted across the Granville Street battleground by police holding riot shields over her. Another had to run a gauntlet of hooligans on rooftops throwing bottles down at him.

By 11:30 p.m., ambulances kept out of the downtown core earlier for safety reasons began bringing patients in.

“They’d open the door and now there’s not one person in the back, there’s five or six or seven,” Munro says.

One badly beaten man, who had tried to stop rioters, had received a cupcake from a St. Paul’s staffer. “He really needed that,” Graham says. “He was just so happy to get a cupcake.”

Another man had been attacked and injured for wearing a Boston Bruins shirt. Before he was discharged, staff offered him a different shirt. “He wouldn’t take the other shirt,” Graham says. “He said, ‘Nope, I’m a supporter.’”

Then, in spite of decontamination efforts, emergency staff and patients began experiencing symptoms of tear-gas exposure. Police had fired the noxious substance down the street, and it had been sucked into a hospital air intake. An engineer was dispatched to shut off the vent.

The resumption of ambulance service to St. Paul’s brought not only loud, drunk, bleeding victims of fights and stabbings but also patients suffering from ailments not related to the riot. “They were wide-eyed,” Graham says. “You’ve got patients with basic medical complaints who are sitting there staring and thinking, ‘What the heck’s going on here?’”

Hospitalized patients who were supposed to be discharged that night were kept in till the next morning. “We would’ve pushed them out into the middle of a riot,” Graham says.

Around 3 a.m., the chaos began to subside. “You had a moment to actually sit and go, ‘Wow, what did we actually go through?’” Graham remembers.

Echoes of the night’s events continued the next day and beyond. Driving through downtown on her way home, “seeing everything broken and shattered and cars destroyed on the side of the road, it was pretty surreal,” Graham says. Over the next couple of days, she saw TV news reports featuring rioters and riot victims, including two she’d treated for injuries. “I’m seeing them getting stomped on, getting kicked,” Graham says. “It was pretty surprising.”

For Graham, the true test of the emergency department’s riot response is comparison with a typical night. “We actually provided the care we would have any other night,” she says.

It was, of course, not any other night. “It was the epitome of why I went into emergency nursing,” Graham says. “We love action. We’re emergency nurses for a reason.”

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